• Nouchine Hadjikhani, Noreen Ward, Jasmine Boshyan, Vitaly Napadow, Yumi Maeda, Andrea Truini, Francesca Caramia, Emanuele Tinelli, and Caterina Mainero.
• Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, MA, USA.
• Cephalalgia. 2013 Nov 1;33(15):1264-8.

BackgroundMigraine is a neurovascular disorder in which altered functional connectivity between pain-modulating circuits and the limbic system may play a role. Cortical spreading depression (CSD), which underlies migraine aura (MWA), induces C-fos expression in the amygdala. The role of CSD and amygdala connectivity in migraine without aura (MwoA) is less clear and may differentiate migraine from other chronic pain disorders.MethodsUsing resting-state functional MRI, we compared functional connectivity between the amygdala and the cortex in MWA and MWoA patients as well as in healthy subjects and in two other chronic pain conditions not associated with CSD: trigeminal neuralgia (TGN) and carpal tunnel syndrome (CTS).ResultsAmygdala connectivity in both MWA and MWoA was increased to the visceroceptive insula relative to all other groups examined.ConclusionThe observed increased connectivity within the limbic/viscerosensory network, present only in migraineurs, adds to the evidence of a neurolimbic pain network dysfunction and may reflect repetitive episodes of CSD leading to the development of migraine pain.

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